NEUROMODULATION OF THE PRE-FRONTAL CORTEX BY rTMS AND NEUROFUNCTIONAL TRAINING IN CHILDREN WITH AUTISM SPECTRUM DISORDER: RANDOMIZED CONTROLLED DOUBLE-BLIND CLINICAL TRIAL EUROMODULATION OF THE PRE-FRONTAL CORTEX THROUGH rTMS AND NEUROFUNCTIONAL TRAINING
DOI:
https://doi.org/10.37951/2596-1578.cipeex.2024.12514Palavras-chave:
Autism spectrum disorder, gait, balance, child, physiotherapy, transcranial magnetic stimulationResumo
The objective of the study project is to compare the functional effects of ten sessions of neurofunctional training associated with repetitive transcranial magnetic stimulation (rTMS) on the active and placebo dorsolateral prefrontal cortex in children with ASD. This is a randomized, placebo-controlled, double-blind clinical trial involving 24 children diagnosed with ASD, aged between three and eight years. The children will be randomly allocated into two groups: Experimental group - neurofunctional training and active rTMS, and Control group - neurofunctional training and placebo rTMS. The participants will be evaluated one week before the intervention, one week and one month after the end of the interventions, using the Childhood Autism Rating Scale, the Autism Classification System: Social Communication, timed up and go, the 10-meter walk test, the Pediatric Balance Scale, and the Participation and Environment Measure for Children and Youth. The interventions will be held five times a week, carried out over two consecutive weeks. rTMS will be applied to the left dorsolateral prefrontal cortex for 20 minutes, at a high frequency (5Hz). After the application of rTMS, the participants will undergo neurofunctional training for 20 minutes. The neurofunctional training will consist of an activity circuit (10 minutes) and treadmill gait training (10 minutes). The results will be statistically analyzed assuming a significance level of p≤0.05.
Referências
FRANJOINE, M. R.; GUNTHER, J. S.; TAYLOR, M. J. Pediatric balance scale: A modified version of the Berg Balance Scale for the school-age child with mild to moderate motor impairment. Pediatric Physical Therapy, v. 15, n. 2, 2003.
GALVÃO, É. R. V. P.; CAZEIRO, A. P. M.; DE CAMPOS, A. C.; LONGO, E. Medida da Participação e do Ambiente - Crianças e Jovens (PEM-CY). Revista de Terapia Ocupacional da Universidade de São Paulo, v. 29, n. 3, p. 237–245, 30 nov. 2018.
LIU, A.; GONG, C.; WANG, B.; SUN, J.; JIANG, Z. Non-invasive brain stimulation for patient with autism: a systematic review and meta-analysis. Frontiers in Psychiatry, v. 14, 29 jun. 2023.
MARTÍN-DÍAZ, P.; CARRATALÁ-TEJADA, M.; MOLINA-RUEDA, F.; CUESTA-GÓMEZ, A. Reliability and agreement of the timed up and go test in children and teenagers with autism spectrum disorder. European Journal of Pediatrics, v. 182, n. 8, p. 3577–3585, 25 maio 2023.
PEREIRA, A. M.; RIESGO, R. S.; WAGNER, M. B. Childhood autism: Translation and validation of the Childhood Autism Rating Scale for use in Brazil. Jornal de Pediatria, v. 84, n. 6, 2008.
REINDAL, L.; NÆRLAND, T.; WEIDLE, B.; LYDERSEN, S.; ANDREASSEN, O. A.; SUND, A. M. Age of First Walking and Associations with Symptom Severity in Children with Suspected or Diagnosed Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, v. 50, n. 9, 2020.
SIVARAJAH, L.; KANE, K. J.; LANOVAZ, J.; BISARO, D.; OATES, A.; YE, M.; MUSSELMAN, K. E. The Feasibility and Validity of Body-Worn Sensors to Supplement Timed Walking Tests for Children with Neurological Conditions. Physical & Occupational Therapy In Pediatrics, v. 38, n. 3, p. 280–290, 27 maio 2018.
TAJIK-PARVINCHI, D.; ROSENBAUM, P.; HIDECKER, M. J. C.; DUKU, E.; ZWAIGENBAUM, L.; RONCADIN, C.; GEORGIADES, S.; GENTLES, S.; FANG, H.; DI REZZE, B. Construct Validity of the Autism Classification System of Functioning: Social Communication (ACSF:SC) Across Childhood and Adolescence. Journal of Autism and Developmental Disorders, v. 53, n. 8, p. 3246–3256, 6 ago. 2023.
ZIEMANN, U. TMS Induced Plasticity in Human Cortex. Reviews in the Neurosciences, v. 15, n. 4, jan. 2004.
